March 16, 2020
David A. Wein, M.D. is the Chief of Emergency Medicine at Tampa General Hospital, System Medical Director for TeamHealth, and an Associate Professor at USF Morsani College of Medicine.
Rachel Elias Wein: We’re trying to give our readers some context about how they can continue to stay safe and provide good counsel to their team members as well as retailers in their shopping centers.
Let’s start with personal precautions. What are the best ways for us to stay safe personally for ourselves and our families? Also, what are the best resources for up-to-the-minute changes?
Dr. David Wein: I’ll start with the resources first. There are two that I would point most people to: the first is CDC.gov. It has some very good information, both for medical professionals and the public at large. It is kept very up to date.
The other one I would point to is your state or local department of health website, which may have some local resources and recommendations. Most states also have a hotline number that is generally answered fairly quickly. They do get overwhelmed at times, but they can direct you to local resources and provide additional information as well.
In terms of general safety, we have reached a point where we need to be responsible for each other. A lot of us have probably heard that young people seem to do well, and that older people are more prone to severe illness. But bear in mind that when we are talking about someone doing well or having mild symptoms, they still may be fairly sick, even requiring hospitalization. At times the illness is still classified as “mild” because that person has not needed a breathing machine.
When we talk about safety, we know that social distancing is important to slow the spread of infection. That means avoiding crowds, and it does not have to be really large crowds. In fact, it can be any number of people. Sometimes that could even mean family gatherings. I know that can be the most difficult to try to avoid.
We have to go to the grocery store or to other places to get essentials, but we should take reasonable precautions. Wipe down the grocery cart. Wash your hands.
If you feel sick, that is a different story. If you have any symptoms of respiratory illness, stay home.
REW: If you don’t feel well, how do you know when to call the doctor or go to the hospital? What are some signs that we can be looking for?
DW: If you generally feel unwell, have a mild fever and are tired—maybe you have a mild cough—you don’t need to go straight to the hospital. If you’re unsure, you can call your doctor or try a telehealth visit. Seek urgent medical care if you are short of breath or are having difficulty breathing, or if you feel so weak or tired that you find it difficult to get out of bed or move around.
Usually, the first sign we are seeing is being short of breath in situations where you would not normally be.
REW: People have asked me about having gatherings while kids are out of school. Are there any guidelines that we should be using?
DW: The fewer people you come in contact with outside of your family unit the less likely you are to become sick or infect others. As a reminder, people are contagious before they show symptoms.
REW: How about those of us who are running businesses or making decisions in the workplace? Should we ask everyone to work from home?
DW: Anyone with any type of symptom of fever or cough should stay at home. That same is true of anyone who has had any exposure to someone they suspect is ill. But the prior recommendation is the same for the workplace; the fewer people you come in contact with the safer you, your family, and community are.
REW: Let’s talk about the world of retail real estate. Do distancing guidelines apply?
DW: There is no perfect guideline. If someone is sick, even if they are six feet apart from you and they cough on a surface, you can still be infected. That’s why just avoiding being together is best. Essential services like food, grocery and pharmacy are going to stay open. It would not surprise me to see, in the near future, potentially either temperature checks or questions before people are allowed to enter: ‘Have you felt sick? Do you have a fever?’
It is also not unreasonable to bring hand sanitizer with you or to clean surfaces with disinfectant wipes.
REW: A number of retailers have recently seen success with pick-up options. We will likely be testing that infrastructure soon, possibly even requiring pickup or delivery only. Also, it looks like we may be seeing Target, Walmart, CVS, and Walgreens with Covid-19 testing in their parking lots.
DW: This is very interesting. In talking to colleagues across the country, many communities are trying to figure out how to establish community-based testing centers. They want to identify people who may not be sick enough to require hospitalization or acute care but who have some mild symptoms and should be tested to mitigate the spread of the virus. Having locations for that could be helpful.
REW: Any last thoughts we should keep in mind?
DW: If you are concerned that you should seek medical care, it may be better to call ahead to either your doctor or your department of health. There may be tele-screening services available. You certainly don’t want to be stuck at home getting worse without seeking care. But at a time like this, an initial phone call or virtual contact may be better than going directly to an emergency department.